HANDICAPPED CHILDREN.pptx

MENTALLY, PHYSICALLY HANDICAPPED CHILDREN

1. PHYSICALLY ,MENTALLY &SOCIALLY CHALLANGED CHILDREN Guided by; Mrs grace mane hod child health nursing Ine Mumbai PRESENTATION BY; MS CHARUTA KUNJEER FINAL YEAR MSC STUDENT INE MUMBAI

2. AIM: At the end of the seminar the students will be able to gain in-depth knowledge related to physically mentally socially challenged children and will be able to apply in various clinical settings.

3. Objectives: The students will be able to: Define handicapped children. Know the classification of handicapped children. List the problems faced by handicapped children. Explain about the concept of physically handicapped children. Explain about the concept of mentally handicapped children. Explain about the concept of socially handicapped children. Describe the treatment modalities. Explain about the prevention of handicapped children.

4. HANDICAPPED CHILDREN Handicapped child is one who deviates from normal health status either physically, mentally or socially and requires special care, treatment and education.

5. DEFIN I TI O N According to WHO, the sequence of events leading to disability and handicapped conditions are as follows Injury or disease Impa i rme nt, Dis a b i li t y , Hand i c a p

6. CLASSIFICATION OF HANDICAPPED CHILDREN Physically handicapped Mentally handicapped Social handicapped

7. PHYSICALLY HANDICAPPED CHILDREN

8. BLIND DEAF DUMB CRIPLLED CHILD

9. BLINDNESS According to WHO the inability to count fingers in day light from a distance of 3 meters is defined as blindness.

10. PROBLEM FACED BY BLIND CHILD Problem of attachment Unable to use hand as organ of perception Problem on locomotion Dependence on parents and caregiver Behavioral problems Less social interaction Less playing activity

11. Prevention Of Blindness Provide good antenatal care Immunization – meseals, rubella Genetic counseling and screening Prevent infection Prevent pre term birth and provide excellent neonatal care to pre vent blindness.

12. Vitamin A supplement Health education about eye safety, personal hygiene and nutrition for health promotion Treatment of causes of childhood blindness Retinopathy of prematurity (ROP) Cataract Glaucoma

13. Manag e ment Physiotherapy Orientation and mobility instructors Mobility aid and guides BRAIL t e c h n o l o gy

14. DEAFNESS A person who is not able as we l l as with n o r m al to hear s o me o ne hearing . It can affect one ear or both ears, and leads to difficulty in hearing conversational speech or loud sounds

15. LEVELS OF HEARING IMPAIRMENT Mild deafness 25 to 39dB Moderate deafness 40 to 69dB Severe deafness - 70 to 89dB. Profound deafness - 90dB <

16. IMPACT OF HEARING LOSS Functional impact Poor Academic Performance Social and emotional impact Economic impact

17. MANAGEMENT Sign language Hearing devices - hearing aids, assistive listening devices and cochlear implants. lip-reading skills Speech therapy - use of written or printed text

18. SPEECH HANDICAPPED M eans an impairment of S peech or production, sound flue n c y , v o i c e o r l a n g u a g e whi c h a f fects a educational significantly child’s p e rf o rm a n c e s o c i a l , em o ti o n a l , o r th e ir vocational development.

19. TYPE OF SPEECH IMPAIRMENT Articulatio n disorder Fluency disorder stutter i n g Voice disorder A p honia Langua ge disorder

20. I MPACT OF SPEECH IMPAIRMENT Poor Communication skill Less social interactions Behavioral problem - children may feel shame, embarrassment, frustration, anger, and depression as a result of speech impairments. Poor academic performance

21. MANAGEMENT Early identification of speech impairment Elimination of hearing impairment Medical and surgical intervention for underlying causes Psychological counseling Avoid making fun of their voice or speech Voice or Speech therapy Physical therapy Cognitive rehabilitation

22. OR T HO P EDI C A L L Y HANDICAPPED Orthopedic disability occur when movements in over body are affected due to disease, injury, any absence or deformities in the joints, bones, muscles or an injury in nervous system Loco motor disability means disability of the bones, joints or muscles leading to substantial restriction of the movement of the limbs

23. MANAGEMENT Correction Of Deformities Physical Therapy Oc c u p a t i o n a l Therapy Massage Therapy Prosthetics devices for positioning and mobility

24. DEVICES FOR POSITIONING AND MOBILITY Canes Walkers Crutches Wheelchairs Sp e cialized exercise equipment Specialized chairs, desks, and tables for proper posture development

25. MENTAL HANDICAPPED A me n tal h a n d i c ap i s an i n an a b ili t y to impai r m e n t individual's function c o g n it i v e l y , emotionally or physically due to the presence of a psychiatric condition. This hin d e r s condition some o n e ' s perform ability to a task or prevents that person from engaging in an activity without assistance.

26. Mentally handicap children include MENTAL RE T ARD A TIO N CEREBRAL PALSY

27. MENTAL RETARDATION Mental retardation is defined as significantly sub average general intellectual functioning, resulting in association with concurrent impairment in adaptive behaviour, which then manifests during developmental period. (American association on mental deficiency)

28. MENTAL RETARDATION LEVEL Mild - 50- 70* Mod e ra t e - 35-50* Severe - 20-35* Profound <20

29. EFFECT ON CHILDREN Failure to achieve developmental milestones. Deficiencies in cognitive functioning such as inability to learn or to meet academic demands. Expressive or receptive language problems.

30. Psychomotor skill deficits. Difficulty performing self care activities. Neurologic impairments. Medical problems, such as seizures. Low self esteem depression and labile moods. Irritability when frustrated or upset. Lack of curiosity

31. TREATMENT MODALITIES Behavior management. Environment supervision Monitoring the child’s developmental needs and problems. Programs that maximum speech , language, cognitive, psychomotor, social , self care, and occupational skills. Family therapy Early intervention programs for children younger than age 3 with mental retardation. Provide day schools to train the child in basic skills, such as bathing and feeding.

32. CEREBRAL PALSY It i s a d i s a b i li t y that affects ability to control mu s c l es c a u s ed by damage to the b r a i n br a in is while the d e v e l o p i n g .

33. EFFECTS OF CEREBRAL PALSY Abnormal Muscle Tone Abnormal movements Skeletal deformities Seizures Speech problems Swallowing problems Hearing loss: Vision problems Dental problems Bowel and/or bladder control problems

34. Possible signs in a child include: Delays in reaching development milestones – for example, not sitting by 8 months or not walking by 18 months. Seeming too stiff or too floppy (hypotonia) Weak arms or legs. Fidgety, jerky or clumsy movements. Random, uncontrolled movements. Muscle spasms. Shaking hands (tremors)

35. Possible causes  include: Head injuries  as a result of a car accident, fall, or child abuse Intracranial hemorrhage , or bleeding into the brain Brain infections, such as  encephalitis  and  meningitis Infections acquired in the womb, such as  german measles (rubella)  and  herpes simplex Asphyxia neonatorum , or a lack of oxygen to the brain during labor and delivery Gene mutations that result in atypical brain development Severe jaundice  in the infant

36. Cerebral palsy risk factors Certain factors put babies at an increased risk for cerebral palsy. These include: Premature birth Low birth weight A low  apgar score , which is used to assess a baby’s physical health at birth Breech birth,  which occurs when a baby’s buttocks or feet come out first Rh incompatibility , which occurs when the pregnant parent’s blood rh type is incompatible with their baby’s blood rh type The pregnant parent’s exposure to toxic substances, such as illegal drugs, or  medications that damage the fetus Being a twin or triplet

37. DIAGNOSIS PHYSICAL EXAMINATION Electroencephalogram (EEG).  An  EEG  is used to evaluate electrical activity in the brain. A doctor may order it when someone is showing signs of  epilepsy , a primary cause of seizures. MRI.  An  MRI  uses powerful magnets and radio waves to produce detailed images of the brain. A healthcare professional may perform an MRI in order to identify brain irregularities or injuries.

38. CT scan.  A  CT scan  creates clear, cross-sectional images of the brain. It can also reveal brain damage. Ultrasound.  A cranial ultrasound is a method of using high-frequency sound waves to get basic images of a young infant’s brain. It’s relatively quick and inexpensive.  Blood tests.  A healthcare professional may take and  test  a sample of blood in order to rule out other possible conditions, such as  bleeding disorders .

39. TREATMENT Treatment for cerebral palsy include: Speech therapy Occupational therapy Physical therapy Recreational therapy Counseling or  psychotherapy Social services consultations

40. SOCIALLY CH A LLENGED CHILDREN

41. SOCIALLY CHALLENGED CHILDREN A Socially handicapped children may be defined as a child whose opportunity for a healthy personality development and full unfolding of potentialities are hampered certain elements in his social environment such as p a r e n t al in a de q ua c y , environmental deprivation, (lack of learning opportunity ) and emotional disturbance

42. CATEGORY OF SOCIALLY HANDICAPPED CHILDREN Orphan Neg l e c ted children Children of divorce or step parents Deli n qu e nt children

43. ORPHAN CHIL D REN A n orpha n is a c h ild permanently bereaved of or abandoned his or her parents. a child lost both parents is called orphan does not have any surviving parents to care for him or her

44. PROBLEM ASSOCIATED WITH ORPHANS D e v e lop m e n tal retardation Conduct and sleep problem Personality problem Bed wetting Disturbance in eating Depression During adulthood Antisocial problem Drug addiction Alcoholism Marital problem

45. CHILD NEGLECT and attention to a child's needs , including food and a safe environment , or to a child's emotional needs including warmth, security and love. A lack of these things are likely to result in serious damage to children health. ongoing pro v i d e the failu r e right C h ild negle c t i s an to c a re

46. TYPES OF CHILD NEGLECT

47. P arental mental health problems such as depression Unstable and abusive relationships between parents P arental history and learned parental behavior L ack of knowledge of children's needs, A n inability to plan, lack of confidence about the future,

48. Being a teenage mother, Alcohol and drug abuse in care-givers Unemployment Poverty A large number of children, High levels of stress Domestic violence

49. CONSEQUENCES OF NEGLECT Developmental delays- socialize Delayed physical and mental growth, Neurological impairments. Poor social skills, Experience extended poverty or unemployment Face chronic illnesses or early death. Cognitive deficits,

50. Emotional development problems Unusual fussiness, fear, or Lack of interest in activities. Being anxious or avoiding people Difficulty in making friends Being withdrawn. The effects on behavioral development Anti-social behavior Early sexual activity

51. Poor mental health, such as exhibiting low self-esteem, anxiety, depression, or suicidal tendencies. Insecure-anxious attachment. Attachment difficulties and difficulty in formation of relationships in the future Affects intellectual ability and cognitive/ Sudden decline in academic performance. Anxiety or impulse-control

52. Failure to thrive” Obviously unhealthy Dirty or have poor personal hygiene or Inadequately clothed. The effects may last into adulthood and may cause a person to neglect their own children later in life.

53. Manag e ment For parents Treatment for Substance abuse. Depression or other mental health problems. Low self-esteem Violent behavior Realize responsibility regarding child Educating and helping parents to correct their erroneous thinking and behavior or parenting skill

54. Cont…. For child Child-centered interventions include Pediatric care, mentoring Behavioral and mental health treatment. Provide stimulation programme to emotionally neglected child Develop timely and comprehensive assessments or placed in foster home

55. CHILDREN OF DIVORCED OR SEPRATED PARENTS a l wa y s even a f fe c t s a d ult A d i v o r c e children, children, an d d i v o r c e is a l mo s t a l wa y s s t r e s s ful for c h il d re n . And contact with l e ad to l o st o n e p a r e nt, c r e a te eco n omic h a r d s h i p s , and increase c o nf l i ct be t ween these pa r en t s For a l l r e a s o n s, mo s t c h il d r e n hav e a har d ti m e during the divorce transition.

56. EFFECTS OF DIVORCE OR SEPERATION ON CHILDREN Infants Loss of appetite. Upset stomach — may spit up more. More fretful or anxious. Toddlers More crying Sleeping Problem May feel anger May worry when parent is out of sight. May withdraw, bite or be irritable. Temper tantrums

57. Preschoolers Feels uncertain about the future. May feel responsible. May hold anger inside. May become aggressive and angry toward parent he/she lives with. May have more nightmares. Experiences feelings of grief because of sudden absence of parent.

58. Cont…. Early elementary Feels unfaithful and feels a sense of loss. Feels rejected by the parent who left. Ignores school and friendships. Worries about the future. Complains of headaches or stomachaches. Experiences loss of appetite, sleep problems, diarrhea, urinary frequency. Learning problem in school

59. Cont…. teenagers and adolescents Feels angry and disillusioned. Feels abandoned, that parent is leaving him/her not the other spouse. Shows extreme behavior (good and bad). Involved in high-risk behaviors (drugs, shoplifting, skipping school). Anti social behavior Drug or alcohol abuse Problem in maintaining relationship. Worries about financial matters.

60. MANAGEMENT Not expose child to conflict between parents Listen to child and provide emotional support Child should be reared to respect to both parents Child should taught that both parents are nice people but are separating because of they have different views about life

61. PREVENTION OFHANDIC A PPED CONDITION IN CHILDREN

62. PRIMARY PREVENTION Genetic counseling Genetic screening Reduction of consanguineous marriage Pregnancy planning Rh incompablity Immunization of mother and baby Vitamin A prophylaxis Improve nutritional status of mother and child

63. Cont…. Prevention of iodine and folic acid deficiency Provide essential care in prenatal, Intranatal, postnatal period Prevent maternal and neonatal infection Prevent birth injury, asphyxia, hyperbilurubinemia Special care to high risk mother –abortion, premature birth Encourage to kick bad habits such as smoking or alcohol abuse.

64. SECONDARY PREVENTION Careful history Regular medical supervision and developmental assessment Tereatment of particular handicap condition Correction of deformity Physiotherapy and exercise to improve physical condition Occupational therapy

65. Cont… Speech therapy to improve communication ability Prosthetics Special care for mentally handicapped children with warmth , love , tolerance, discipline, avoid criticism Counseling and guidance Referral for welfare services

66. REHABILITATION OF HANDICAP CHILDREN Medical rehabili t ation Social reh a bili t ation Educational rehabili t ation Ps y c h olo g ical rehabilitation Vocational reh a bili t ation

67. WELFARE OF HANDICAPPED CHILDREN

68. WELFARE OF HANDICAPPED CHILDREN Persons with disabilities bill (equal opportunity, protection of right and full participation)- 1995,introduced by ministry of welfare and Govt of India and it deal with preventive and promotional aspect of rehabilitation Children Act 1960- provide for the care protection, maintenance, welfare, education, and rehabilitation of socially handicapped children.

69. Schemes for handicapped children Deendhyal disabled rehabilitation scheme Assistance to disabled person to purchase or fitting of aids and appliance National handicapped finance and development cooperation Scheme for implementation of person with disabilities act 1995(sipda) Scheme for incentive to employees in the private sector for providing employment to person with disabilities

70. National institute for handicapped National institute for orthopedically handicapped Calcutta National institute for mentally handicapped Hyderabad Ali yavar Jung National institute for hearing handicapped Mumbai National institute for rehabilitation, training, and research Calcutta National Institute for visually handicapped new Delhi and Dehradun

71. NURSING MANAGEMENT OF HANDICAPPED CHILDREN Ineffective family coping and altered parenting related to handicapped condition Anxiety of parents and family members Altered nutrition less than body requirement Potential for infection Self care deficient Communication impaired Physical mobility impaired

72. Cont….. Altered elimination pattern Activity intolerance Altered sleep pattern Sensory alteration, visual/ auditory Altered growth and development Diversional activity deficit Knowledge deficit to continued care of handicapped children

73. Con c lusion H andicap develops as the consequence of the disability. It is defined as a disadvantage for a given individual resulting from impairment or a disability that limits and prevents the fulfillment of a role which is normal for that individual, depending on age, sex, social and cultural factors.

74. BIBLIOGRAPHY Paraul Datta, Pediatric Nursing, Second Edition, Jaypee Publication, Page No.177-184 R  Sreevani  , A Guide to  Mental Health  and  Psychiatric  Nursing ; Edition, 4, Publisher , Jaypee Brothers Medical  Dorothy Marlow, Textbook Of Pediatric Nursing, South Asian Edition ,Page No. Rimple Sharma’s, Essentials Of Pediatric Nursing, Second, Page No.629-644 Ghai Essentials Pediatrics, Ninth Edition, Cbs Publishers And Distributors, Page No. Wongs , Essentials Of Pediatric Nursing, Eight Edition,elsevier , Page No.554-559